e. 2nd/3rd Tri Path P1

which is the most common type of nonlethal fetal

a) Osteogenesis Imperfecta Type 2

b) Thanatophoric skeletal dysplasia

c) heterozygous achondroplasia

d) achronogenesis

c) heterozygous achondroplasia

what are the expected US finding in vasa previa

a) the internal os is covered by a large blood clot caused by placenta abruption

b) the internal os is covered by the umbilical vessel attachment to a low lying or marginal placenta

c) the internal os is completely covered by the base of the placenta

d) placenta percreta where the endometrium has invaded the myometrium + serosa causing hemorrhage

b) the internal os is covered by the umbilical vessel attachment to a low lying or marginal placenta

in the 2nd trimester, documenting a normal lens in each eye on the fetal US can rule out

a) arhinia

b) holoprosencephaly

c) stigmatism

d) cataracts

d) cataracts

a maternal hx of hyperthyroidism or hypothyroidism will usually have what effect on the fetus

a) macrosomia, hepatomegaly

b) no effect

c) fetal demise

d) hydrops

c) fetal demise

a trident hand is commonly seen w/which skeletal abn

a) heterozygous achondroplasia

b) spina bifida occulta

c) ostenogenesis imperfecta 2

d) spina bifida aperta

a) heterozygous achondroplasia

in twin to twin transfusion, the donor twin shows

in twin reversed arterial perfusion sequence, the donor twin shows

a) pleural effusion, ascites

b) growth restriction, hydrops

c) congestive heart failure, no cardiac structure

d) polyhydramnios, oligohydramnios

b) growth restriction

a pt has scan for 26w. the head circumference, biparietal diameter, and femur length measure 25.5w. the abd circumference measure 28.5w

a) asymmetric IUGR

b) hepatic mesenchymal hamartoma

c) symmetric IUGR

d) hydrops

b) hepatic mesenchymal hamartoma

what about Dandy Walker malformation is true

a) DMW is more commonly an isolated finding w/o other defects

b) is frequently assoc w/agenesis of corpus callosum; malformation of the heart, face, limbs, and digits

c) a neonate w/DMW will usually develop normal intelligence + no long terms effects on brain function

d) DMW is caused by cystic dilation of the 3rd ventricle

b) is frequently assoc w/agenesis of corpus callosum; malformation of the heart, face, limbs, and digits

while evaluating the fetal brain of 27w, you see an anechoic space midline in the cerebrum. the space appears to communicate w/an anechoic tubular structure coursing inferiorly. color doppler shows low velocity, swirling flow in the structures

a) vein of galen pseudoaneursym

b) aqueductal stenosis

c) dandy walker malformation

d) vein of galen aneurysm

d) vein of galen aneurysm

which describes the findings

a) there is large amount of meconium funneled toward the cervix

b) a chorioangioma has formed at the internal os

c) the maternal bladder is too full accurately

d) complete placenta previa

d) complete placenta previa

tetralogy of fallot consists of a group of 4 primary cardiac defects that include right ventricular hypertrophy, VSD, pulmonary stenosis, and

a) small left ventricle

b) aortic coarctation

c) overriding AO

d) interrupted IVC

c) overriding AO

encephalocele + polydactylyl is noted. these findings are most suggestive of

a) trisomy 13

b) meckel gruber syndrome

c) trisomy 18

d) turner syndrome

b) meckel gruber syndrome

the most commonly reported intrauterine infection in pregnancy is

a) staphylococcus

b) cystomegalovirus

c) HIV

d) PID

b) cystomegalovirus

which is not considered a critical finding on a fetal US

a) placental abruption

b) circummarginate placenta

c) umbilical cord knot

d) cervical pregnancy

b) circummarginate placenta

a circumvallate placenta

a) causes placental thickening assoc w/fetal hydrops

b) is caused by back folding of the placenta + fetal membranes toward the chorionic surface

c) is commonly assoc w/chromosomal anomalies

d) causes placental insufficiency + IUGR

b) is caused by back folding of the placenta + fetal membranes toward the chorionic surface

you are doing a follow-up limited scan because the stomach + kidneys at 15 weeks weren’t seen. on today’s exam, you see a single normal kidney but the stomach remains barely visible. borderline polyhydramnios + rocker bottom feet is present. the head measures 3 standard deviations lower than the abdomen and femoral measurements.

a) Ellis Van Creveld

b) trisomy 13

c) trisomy 18

d) Noonan

c) trisomy 18

what are the arrows pointing to on this 4 chamber heart view

a) hypoplastic left heart

b) multiple echogenic intracardiac foci

c) rhabdomyoma

d) pulmonary sequestration

c) rhabdomyoma

which is most commonly assoc w/abn on the images

a) holt oram syndrome

b) noonan sydrome

c) trisomy 21

d) trisomy 13

c) trisomy 21

which placental grade shows the cotyledons on US exam

a) 0

b) 1

c) 2

d) 3

d) 3

which is true about sono appearance of fetal bowel

a) dilated bowel can be differentiated from a dilated ureter by identifying peristalsis in the bowel segment

b) as the fetus ages, the bowel becomes more hypoechoic

c) anal atresia will lead to inability to see the fetal bowel duw to collapse + atrophy of digestive tract

d) fetal bowel is not normally seen until after 22 weeks

a) dilated bowel can be differentiated from a dilated ureter by identifying peristalsis in the bowel segment

which is not an expected post-partum complication

a) thrombosis/embolism

b) metritis

c) hemorrhage

d) gestational diabetes

d) gestational diabetes

which is least likely to be assoc w/placental abruption

a) placental lakes

b) cocaine use

c) fibroids

d) smoking

a) placental lakes

a) duodenal atresia

b) esophageal atresia

c) posterior urethral valves

d) UPJ obstruction

c) posterior urethral valves

which describes asymmetric IUGR

a) the limbs are abn shortened w/relatively normal HC + AC

b) HC measures more than 2 standard deviations smaller than AC for current gestational age

c) the AC measures more than 2 standard deviations smaller than HC for current gestational age

d) all parts of the fetus to be reduced in size by more than 2 standard deviations for current gestational age

c) the AC measures more than 2 standard deviations smaller than HC for current gestational age

which is correct of fetal hydrops

a) Fetal ascites, scalp edema, and skin edema are common sonographic signs of fetal hydrops.

b) If the fetal hydrops is caused by Rh Incompatibility, it is labeled as non-immune.

c) Immune hydrops can be caused by over 120 different diseases/abnormalities/congenital defects

d) Non-immune and immune fetal hydrops can be distinguished from one another by their very different sonographic appearance/characteristics.

a) Fetal ascites, scalp edema, and skin edema are common sonographic signs of fetal hydrops.

___ twins have the highest incidence of umbilical cord knotting

a) conjoined

b) monochorionic/diamniotic

c) monochorionic/monoamniotic

d) dichorionic/diamniotic

c) monochorionic/diamniotic

while performing a scan on a 21 week fetus, you see ectopia cordis, club foot, and asymmetric cleft lip/palate.

a) amniotic band sequence

b) pentalogy of cantrell

c) tetralogy of fallot

d) patau syndrome

a) amniotic band sequence

pt has her 1st US at 22w. a twin pregnancy w/1 placenta. fetus A shows increased C/T ratio, mild pleural effusion, and anasarca. No cardiac activity can be identified in fetus B. there is no obvious cranial or cerebral structure

a) fetus A - hydrops, fetus b - triploidy

b) vanishing twin syndrome

c) twin reversed arterial perfusion sequence

d) dichorionic/diamniotic twins

c) twin reversed arterial perfusion sequence

a) echogenic bowel

b) toxoplasmosis infection

c) mesenchymal hamartoma

d) omphalocele

b) toxoplasmosis infection

what is the most common cause for a shift of cardiac axis/position

a) diaphragmatic hernia

b) ectopia cordis

c) congenital cystic adenomatoid malformation

d) chromosomal anomalies

a) diaphragmatic hernia

trisomy 21 is suspected. which image is suggestive of this?

a) A

b) B

c) C

d) D

d) D

a) club foot + syndactyly

b) arthrogryposis + polydactyly

c) club foot + polydactyly

d) rocker bottom foot + polydactyly

c) club foot + polydactyly

which is not a cause for this abn

a) anencephaly

b) aqueductal stenosis

c) chiari malformation

d) teratoma

a) anencephaly

which trisomy is commonly assoc w/radial ray anomalies

a) 13

b) 18

c) 21

d) 23

b) 18

severe chest + lung hypoplasia is suspected if the thoracic circumference is

a) <5th percentile

b) <15th percentile

c) <18th percentile

d) <25th percentile

a) <5th percentile

a solid mass is attached to the ventral wall of a 22w fetus. there is no abd wall or fetal skin covering the mass, but the abd vasculature appears to be shared between the fetus and the mass

a) parasitic conjoined twins

b) gastroschisis

c) omphalocele

d) prune belly syndrome

b) gastroschisis

this is ___ which is a common finding in

a) cystic hygroma, monosomy x

b) hypertelorism, trisomy 21

c) cerebellar agenesis, dandy walker syndrome

d) hypotelorism, trisomy 13

d) hypotelorism, trisomy 13

a) pericardiac effusion

b) pleural effusion

c) hydronephrosis

d) ascites

b) pleural effusion

esophageal atresia is a significant indication for trisomy

a) 13

b) 18

c) 20

d) 21

b) 18

if an isolated cystic hygroma is present, AFP levels will be

if cystic hygroma is present w/turner syndrome AFP levels will be

a) decreased, increased

b) normal, decreased

c) normal, increased

d) increased, decreased

b) normal, decreased

hypoplasia of the ___ is a soft marker of trisomy 21

a) distal phalanx of the 5th digit

b) middle phalanx of the 3rd digit

c) distal phalanx of the 3rd digit

d) middle phalanx of the 5th digit

d) middle phalanx of the 5th digit

a) holoprosencephaly

b) lisssencephaly

c) iniencephaly

d) schizencephaly

d) schizencephaly

microtia is a strong indicator of

a) triploidy

b) trisomy 21

c) trisomy 18

d) turner syndrome

b) trisomy 21

which is uterine synechia

a) top left

b) top right

c) bottom middle

b) top right

a monochorionic diamniotic twin pregnancy shows 2 female fetuses w/normal fetal heart rates. fetus A is 25% larger than fetus B. fetus A haspolyhydramnios. fetus B has oligohydramnios

a) vanishing twin syndrome

b) molar twin pregnancy

c) twin reversed arterial perfusion sequence

d) twin to twin transfusion

d) twin to twin transfusion

a small, undeveloped right ventricle, right atrium and pulmonary artery are collectively referred to as

a) noonan syndrome

b) ebstein anomaly

c) double outlet right ventricle

d) hypoplastic right heart syndrome

d) hypoplastic right heart syndrome

the most common cardiac defect seen w/trisomy 21

a) patent ductus arteriosus

b) ventricular septal defect

c) AV canal defect or AVSD

d) atrial septal defect

c) AV canal defect or AVSD

what intracranial anomaly is commonly assoc w/

a) holoprosencephaly

b) lissencephaly

c) dandy walker malformation

d) vein of galen aneurysm

a) holoprosencephaly

ebstein anomaly is

a) abn placement of tricuspid valve more inferiorly into the apex of right ventricle

b) abn placement of tricuspid valve more inferiorly into the apex of left ventricle

c) abn placement of the mitral + tricuspid valves more inferiorly into the apex of the ventricles

d) abn placement of the mitral valve more inferiorly into the apex of left ventricle

a) abn placement of tricuspid valve more inferiorly into the apex of right ventricle

which syndrome is commonly assoc w/this renal abn on this coronal image

a) turner

b) down

c) edward

d) potter

d) potter

which is true regarding autosomal dominant polycystic kidney disease

a) requires 2 abn genes

b) occurs unilaterally

c) assoc w/early fetal demise

d) at least one parent has ADPKD

d) at least one parent has ADPKD

what is seen on this coronal view of thoracic + lumbar spine

a) normal lung tissue

b) enlarged echogenic kidney

c) renal agenesis

d) abn splaying of vertebral bodies

c) renal agenesis

when evaluating the AC of a 30w fetus, you see the umbilical vein curves to the left to the stomach + GB is medial to vein. AC + skin thickness measurements are normal

a) persistent right umbilical vein

b) absent ductus venosus

c) situs inversus

d) normal anatomy

a) persistent right umbilical vein

a) diaphragmatic hernia

b) normal lung tissue in 3rd trimester

c) congenital cystic adenomatoid malformation type 2

d) Congenital cystic adenomatoid malformation type 3

d) congenital cystic adenomatoid malformation type 3

a pt comes in for 20w measuring 12 days behind where they should be according to their 1st trimester scan. the cranial bones appear less echogenic. the humerus + femur appear slightly bowed. the small bones in the extremities are also somewhat difficult to identify due to decreased echogenicity

a) achondroplasia

b) thanatophoric dwarfism

c) IUGR

d) osteogensis imperfecta

d) osteogenesis imperfecta

polyhydramnios is dx when the 4 quadrant fluid level is greater than

a) 15 cm

b) 28 cm

c) 12 cm

d) 25 cm

d) 25 cm

a pt at 20w for suspected Eagle Barrett syndrome. which fetal structure should be closely evaluated

a) kidneys + bladder

b) amniotic bands

c) fetal brain

d) stomach + bowel

a) kidneys + bladder

if the LVOT + RVOT are parallel as they exit the fetal heart

a) complete transposition of the great vessels

b) truncus arteriosus

c) tetralogy of fallot

d) normal cardiac outflow anatomy

a) complete transposition of the great vessels

a pt has higher than expected bHCG. her LMP was 8 weeks ago

a) normal twin pregnancy

b) heterotropic pregnancy

c) twin pregnancy in bicornuate uterus

d) twin pregnancy in septate uterus

b) heterotropic pregnancy

____ is displayed and it’s a common finding

a) aqueductal stenosis, trisomy 21

b) alobar holoprosencephaly, trisomy 13

c) dandy walker malformation, spina bifida

d) lobar holoprosencephaly, monosomy x

b) alobar holoprosencephaly, trisomy 13

all could cause this expect

a) anal atresia

b) esophageal atresia

c) duodenal atresia

d) mesenteric mass

b) esophageal atresia

what fetal anomaly is this

a) syndactyly

b) club foot

c) rocker foot bottom

d) clinodactyly

b) club foot

a) no cavum septum pellucidum

b) acrania

c) encephalocele

d) anencephaly

d) anencephaly

what is the most commonly identified fetal chest mass

a) diaphragmatic hernia

b) congenital cystic adenomatoid malformation

c) pulmonary sequestration

d) cardiac sarcoma

b) congenital cystic adenomatoid malformation

you’re scanning a 28w fetal heart. a single large trunk vessel exits the heart + pulmonary artery appears to branch from it instead of from the right ventricle

a) truncus arteriosus

b) total anomalous pulmonary venous return

c) partial anomalous pulmonary venous return

d) double outlet left ventricle

a) truncus arteriosus

which characteristics indicates multicystic kidney disease

a) multiple communicating cysts that connect to a dilated ureter

b) multiple noncommunicating cysts that do not connect to a dilated ureter

c) multiple microcysts that cause increased echogenicity of the kidney

d) multiple cysts that replace the renal sinus w/normal renal cortex

b) multiple noncommunicating cysts that do not connect to a dilated ureter

what is anasarca commonly seen with

a) achondrogenesis

b) IUGR

c) fetal hydrops

d) thanatophoric dwarfism

c) fetal hydrops

which skeletal anomalies usually occurs as an isolated finding

a) rhizomelia

b) phocomelia

c) arthrogryposis

d) talipes equinovarus

d) talipes equinovarus

an encephalocele can be easily be mistaken for

a) gastroschisis

b) porencephaly

c) epignathus

d) cystic hygroma

d) cystic hygroma

the findings are

a) hypoplasia left heart

b) normal 4 chamber heart

c) atrioventricular septal defect

d) tetralogy of fallot

c) atrioventricular septal defect

a) frontal bossing

b) normal fetal profile

c) micrognathia

d) proboscis

d) proboscis

a) gastroschisis

b) ectopia cordis

c) normal heart w/oblique view of thorax

d) omphalocele

b) ectopia cordis

a) there are no kidneys identified on either side of the normal lumbar spine

b) there are 2 normal kidneys seen but there is cystic hygroma too

c) there are normal kidneys seen on either side of normal lumbar spine

d) there are 2 normal kidneys seen but spina bifida too

d) there are 2 normal kidneys seen but spina bifida too

a) the heart is abnormally small but the stomach appears normal

b) complete situs inversus

c) partial sinus inversus

d) normal 4 chamber heart + stomach

c) partial sinus inversus

pt w/22w GA fetus. this is placental cord insertion

a) velamentous cord insertion

b) marginal cord insertion

c) cyst originating from the umbilical cord

d) a normal placental cord insertion

a) velamentous cord insertion

a) duodenal atresia

b) posterior urethral valves

c) unilateral multicystic dysplastic kidney

d) autosomal recessive polycystic kidney disease

c) unilateral multicystic dysplastic kidney

a) most likely a female fetus

b) fetus probably has potter syndrome

c) fetus probably has turner syndrome

d) most likely a male fetus

d) most likely a male fetus

common complications of a velamentous cord insertion include vasa previa, IUGR, and

a) choriocarcinoma

b) placental abruption

c) complete molar pregnancy

d) cord entanglement

b) placental abruption

most forms of skeletal dysplasia shows a foreshortened femur throughout pregnancy, except ___ that typically has a normal femur length until later in the 2nd trimester

a) osteogenesis imperfecta

b) campomelic dysplasia

c) Thanatophoric skeletal dysplasia

d) heterozygous achondroplasia

d) heterozygous achondroplasia

which condition is the most common cause of hydronephrosis in a fetus

a) ureteropelvic junction obstruction

b) posterior urethral valves

c) bladder extrophy

d) aqueductal stenosis

a) ureteropelvic junction obstruction

which facial anomaly is commonly assoc w/beckwith wiedemann syndrome

a) frontal bossing

b) proboscis

c) macroglossia

d) midface hypoplasia

c) macroglossia

which describes sono appearance of possible intestinal atresia in a 29w fetus

a) small bowel loops dilated at 3mm luminal diameter

b) decreased or absent peristalsis of bowel

c) hyperechoic bowel w/increased peristalsis

d) pleural effusion, megacystitis + ascites

b) decreased or absent peristalsis of bowel

symmetric IUGR occurs when

a) HC measures more than 2 standard deviations smaller than AC for the current GA

b) the limbs are abn shortened w/relatively normal HC + AC

c) AC measures more than 2 standard deviations smaller than HC for the current GA

d) all parts of the fetus to be reduced in size by more than 2 standard deviation for current GA

d) all parts of the fetus to be reduced in size by more than 2 standard deviation for current GA

macrosomia describes a fetus weighing more than

a) 3,000g

b) 10lbs

c) 4,000g

d) 2,000g

c) 4,000g

which anomaly is almost always assoc w/tracheoesophageal fistula

a) esophageal atresia

b) megacystitis

c) duodenal atresia

d) bochdalek hernia

a) esophageal atresia

all can cause a false positive dx of club foot except

a) oligohydramnios

b) uncooperative fetus

c) 8cm intramural fibroid

d) footling breech position

b) uncooperative fetus

what delivery complication is most commonly assoc w/velamentous cord insertion

a) meconium peritonitis

b) vasa previa

c) fetal respiratory distress

d) premature rupture of membranes

b) vasa previa

a) normal grade 2 placenta

b) circumvallate placenta

c) placenta previa

d) placental abruption

b) circumvallate placenta

if you identify hypoplastic left heart in a female fetus, what fetal syndrome should be suspected

a) edwards

b) turner

c) triploidy

d) noonan

b) turner

what is the most common cause of death in lethal skeletal dysplasia

a) umbilical cord knot

b) renal failure

c) pulmonary hypoplasia

d) hypoplastic heart

c) pulmonary hypoplasia

monochorionic twins over 16w GA should be evaluated every 2 weeks for possible complications. Doppler evaluation of the ___ for discordant flow resistance and evaluation of the ___ for discordant flow velocities must be included in the exams

a) umbilical artery, middle cerebral artery

b) middle cerebral artery, umbilical artery

c) uterine artery, umbilical artery

d) ductus venosus, uterine artery

a) umbilical artery, middle cerebral artery

which is true about micrognathia? it is seen w/

a) polyhydramnios in 70% of cases due to dyphagia

b) oligohydramnios in 70% of cases due to dysphagia

c) oligohydramnios in 70% of cases due to assoc renal anomalies

d) polyhydramnios in 70% of cases due to assoc renal anomalies

a) polyhydramnios in 70% of cases due to dyphagia

what is the most common cause for this abn

a) spina bifida

b) aqueductal stenosis

c) mass effect from neuroblastoma

d) chiari malformation

b) aqueductal stenosis

what is this cardiac defect

a) patent foramen ovale

b) aortopulmonary window

c) sinus venosus ASD

d) muscular VSD

d) muscular VSD

a) turner syndrome

b) trisomy 13

c) trisomy 18

d) trisomy 21

d) trisomy 21

this is ___ and it’s assoc w/

a) vein of galen aneurysm, congestive heart failure

b) dilated 3rd ventricle, spina bifida

c) agenesis of corpus callosum, triploidy

d) middle cerebral artery aneurysm, fetal demise

a) vein of galen aneurysm, congenital heart failure

while scanning a 22w fetus, you see normal long bones in lower extremities but the feet are very small w/shortened tarsals + metatarsals.

a) rhizomelia

b) clinodactyly

c) phocomelia

d) acromelia

d) acromelia

a) congenital cystic adenomatoid malformation + pulmonary sequestration

b) potter syndrome + diaphragmatic hernia

c) vein of galen malformation + cardiomegaly

d) thanatophoric skeletal dysplasia + osteogenesis imperfecta

d) thanatophoric skeletal dysplasia + osteogenesis imperfecta

what urinary anomaly is caused by urinary obstruction in the 1st trimester and leads to renal cyst formation + ureteral atresia

a) potter syndrome

b) multicystic kidney disease

c) infantile PCKD

d) adult PCKD

b) multicystic kidney disease

a) diaphragmatic hernia

b) normal thoracic activity

c) cardiomegaly

d) cognenital cystic adenomatoid malformation

a) diaphragmatic hernia